Comparação entre BNP e NT-proBNP quanto à concordância e quanto à influência das variáveis clínicas e laboratoriais

Abstract

Objective:To correlate the serum levels of B type natriuretic peptide and the N-terminal fraction of the pro-B type natriuretic peptide, as well as to analyze the influence of age, obesity, renal failure, left ventricle ejection fraction, diastolic dysfunction, and anemia on serum levels of both markers.Methods:An observational study in which the agreement was compared between these markers in consecutive samples of 138 patients. For the correlation, Pearson's test was used, and p<0.05 was considered statistically significant.Results:A linear association was observed between the B type natriuretic peptide and N-terminal fraction of the pro-B type natriuretic peptide (r = 0.907; p<0.001). When evaluating the categorized measurements as normal and altered, there was good agreement, with 90.6% of agreement classifications (p<0.001) in which altered values of the N-terminal fraction of the pro-B type natriuretic peptide and normal values of the B type natriuretic peptide represented 8.7% of the total; the opposite situation represented 1% of the total. Assessment of the influence of the clinical and laboratorial factors on the levels of natriuretic peptides showed that they rise according to age, but that they fall as the ejection fraction increases. Patients with anemia (p<0.001) or with renal failure (p=0.007) had higher values of both markers. There was no association between obesity and the B type natriuretic peptide.Conclusion:There was satisfactory agreement between the B type natriuretic peptide and the N-terminal fraction of the pro-B type natriuretic peptide. Age, creatinine levels, and hemoglobin, as well as ventricular function, influence the serum levels of both natriuretic peptides.

Peptídeo natriurético cerebral na doença de Chagas crônica: relação com acometimento cardíaco e com o tratamento etiológico prévio / Brain natriuretic peptide in chronic Chagas disease: association with cardiac involvement and previous etiological treatment

“…Uma explicação plausível para a elevação e ausência de associação entre os níveis séricos de BNP e os grupos de pacientes aqui estudados seria a idade avançada dos pacientes, cuja média (DP) foi de 58,0 (8,4) anos. O efeito do envelhecimento e a presença de comorbidades com potencial etiológico para cardiopatias (RAYMOND et al, 2003;CURIATI et al, 2013), poderiam estar tornando os grupos mais homogêneos e, portanto, sem diferença nos níveis de BNP.…”

Association of Estimated Insulin Resistance with N-Terminal B-Type Natriuretic Peptide Concentration in Men with Metabolic Syndrome

“…Instead, an alternative mechanism is proposed, namely, decreased natriuretic peptides release from the heart, rather than clearance by adipocytes, explains the association of obesity and IR with decreased levels of natriuretic peptides [25,26]. is explanation is plausible as BNP and NT-proBNP are produced in equimolar quantities, and their plasma concentrations are highly correlated [27]. It is suggested that lower levels of natriuretic peptides could be a consequence rather than a cause of IR [28], but this opinion is not firmly established [29].…”